This month, Patricia Motus, OTR/L, Director of BFL’s Occupational Therapy Program, discusses the crucial role of OT for Survivors of Domestic Violence with Disabilities.

Background

Survivors of Domestic Violence (physical, emotional, sexual or economical) can carry a range of functional repercussions—from temporary physical injuries to depression to permanent brain injuries after being stuck on the head repeatedly. 

Studies indicate that women with disabilities may be dependent on their partners for financial, physical, or medical support, and thus may stay in abusive relationships for longer periods of time (Helfrich, C.A. (2001). Domestic Abuse Across the lifespan: The role of occupational therapy. West Hazelton, PA: Hawthorne Press). National Institute of Justice [NIJ], 2000). 

Their abusers may withhold necessary equipment such as wheelchairs, braces, medications, and transportation as a means to control them (NIJ, 2000).

These repercussions can negatively affect everyday life functions long after the abusive relationship has ended.

Occupational Therapists (OTs) work with individuals who have conditions that are mentally, physically, socially, developmentally and/or emotionally disabling.   The word “occupation” comes from our belief that we all have “occupational roles” that contribute to who we are (i.e. parent, child, spouse, employee). 

At Barrier Free Living’s Domestic Violence Programs (Freedom House & the Non-Residential Domestic Violence Program, Secret Garden), our OTs assists survivors with disabilities to improve basic motor functions and cognitive and emotional abilities. We also help clients to compensate for loss of function. 

Patricia Motus

BFL’s OT Process

Individual OT interventions begin with a client intake. The OT assesses current functional abilities which allow an individual to participate in activities of daily living. Next, a client-centered plan is designed to help survivors achieve the greatest level of functional independence. 

Skill building groups include Stress Management, Self-Esteem Building Workshops, Cycle of Violence Support, Cooking, Parenting, Yoga and Job Club.

BFL’s OTs also may address: Money Management and Budgeting; Self Care (hygiene); Stress Management; Computer Skills Training; Prevocational and Vocational Counseling; Development of Parenting; Community Mobility; Coping and Interpersonal Skills; Esteem Building, Leisure Management; Home Management; Role Expansion (development of skills needed to acquire desired roles); Time and Pain Management; Environmental Adaptations; Development of a Fitness or Home Exercise Regimen with emphasis on overall health management. 

Survivor’s Story:

Ms. X was referred to Occupational Therapy by her social worker at BFL’s Secret Garden for assistance with her Activities of Daily Living (ADL’s).  

Miss X is a 55 year-old mother of one adult daughter who has never been married. She has a diagnosis of Major Depressive Disorder and Rheumatoid Arthritis and ambulates independently with a rolling-walker. 

Ms. X had a history of crack/cocaine dependence, a behavior she described as a means for her to cope with her childhood. She’s been clean for 3 years and has recently ended a long relationship where her partner was verbally and emotionally abusive and controlling. 

Ms. X has a history of abuse beginning as a young child, at the hands of her heroin-addicted parents. She endured verbal abuse from her father, neglect, emotional and physical abuse from her mother and sexual assault by her step-father. 

At 15, her mother’s sudden passing led to Ms. X and her younger siblings moving in with an abusive family member.   Ms. X did not complete high school as she worked and provided for her younger siblings. 

At. 18, after a suicide attempt, she was psychiatrically admitted, was diagnosed and began taking medication for Depression. At 21, she was involved in an abusive relationship leading to the birth of her only child. 

Her vocational history includes work as recent as 5 years ago when Ms. X’s Rheumatoid Arthritis exacerbated, resulting in severe swelling and pain in both of her knees, preventing her from maintaining employment. 

Since going on disability, Ms. X reported having gained 40 lbs, a possible contributor to her pain.  

Ms. X conveyed a need to lose weight, through better nutrition and exercise. Ms. X expressed difficulty with shopping, cleaning and laundry, tasks her daughter currently assists with.  Ms. X indicated she wanted to gain independence in her home management skills and eventually get her GED and volunteer once her pain became better managed.

Upon Initial Evaluation, the following were identified by Ms. X as specific target areas: Managing her arthritic pain; improving her home management skills, the development of coping skills for anger and depression, vocational exploration and nutrition. 

She worked with BFL’s OT team to successfully develop a plan to guide her forward in her life.

The OT client-centered plan included:

·        Sessions to address pain

·        Online research and education about Rheumatoid Arthritis, Learning and practicing joint preservation techniques as well as compensatory strategies especially those that involve lifting, carrying and bending.

·        Learning edema reduction techniques and the development of a daily stretching and home exercise program.

·        Learning and practicing joint preservation techniques while engaged in household chores/tasks, identifying and obtaining appropriate adaptive equipment such as built-up utensils, reachers and carts, and/or adapting the way in which she currently performs daily tasks.

·        Anger management, and learning to improve her ability to deal and understand her anger, understanding her triggers and practicing strategies such as relaxation techniques and breathing to diffuse her emotions.

·        Attending Cycle of Violence group for assistance in coping with feelings related to the abuse and to help discover self-worth within a supportive group environment.

·        Developing coping strategies for depression by attending Stress Management Group.

·        Developing a vocational plan and readiness for a GED program

·        Nutrition and weight management, openly discussing eating habits, nutritional knowledge, meal preparation abilities, creating of a daily food log, online research on nutrition and examining her monthly budget for affordable and healthier shopping choices.  

Since being referred to OT, Ms. X has successfully begun to address each of the goals outlined in her plan. She is attending a cycle of violence and stress management group at the Secret Garden and has reported that she is recognizing the importance of both her counseling, socializing with peers and the group’s supportive dynamic.

Patricia Motus, OTR/L, has been Director of BFL’s OT program since 2004. She serves as an OT consultant for numerous groups with career concentration in community mental health and psychosocial practice. She is an alumnus of York College of the City University of New York, Queens, New York Bachelor of Science in Occupational Therapy – Cum Laude (1999).